VOL. 11 No. 2 | May 2020

On March 9, 1988, we started trial on Nancy Cruzan’s case in the three-story limestone courthouse on the town square in Carthage, Missouri. One of the many issues we’d end up talking about in the days and months of legal proceedings that followed was withholding versus withdrawing a feeding tube, and how those two acts should present the same legal and ethical challenge. We cited pages 75–77 of the President’s Commission Report titled “Deciding to Forego Life-Sustaining Treatment,” which the government had published 5 years earlier. The reality is I did not really understand exactly how complex that assertion was back then. As the two lead articles in this journal suggest, the questions remain challenging today, 31 years later.